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A rapid favorable outcome after sofosbuvir induced leucocytoclastic vasculitis.
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  • Ines Souilem,
  • Ons Charfi,
  • Imen Hamza,
  • Fatma Zgolli,
  • Sarrah Kastalli,
  • Ghozlane Lakhoua,
  • Sihem El Aidli
Ines Souilem
National Center of Pharmacovigilance

Corresponding Author:[email protected]

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Ons Charfi
Universite de Tunis El Manar Faculte de Medecine de Tunis
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Imen Hamza
National Center of Pharmacovigilance
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Fatma Zgolli
Centre National de Pharmacovigilance
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Sarrah Kastalli
Universite de Tunis El Manar Faculte de Medecine de Tunis
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Ghozlane Lakhoua
National Center of Pharmacovigilance
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Sihem El Aidli
Universite de Tunis El Manar Faculte de Medecine de Tunis
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Abstract

Background: Sofosbuvir, a very effective new direct-acting antiviral agent (DAA), has revolutionized the therapeutic management of people infected with hepatitis C virus. It has a low reported rate of side effects. Leukocytoclastic vasculitis can be associated with hepatitis C but can also be induced by many drugs. We describe a case of leucocytoclasic vasculitis induced by Sofosbuvir that resolved 3 days after drug withdrawal. We observed a temporal relationship between the treatment and the onset of vasculitis. We emphasize the multidisciplinary approach to patients with hepatitis C to make the difference between drug-induced skin damage and damage caused by the virus itself. Case presentation: A 61-year-old woman, with a history of hepatitis C virus infection started treatment with the combination ledipasvir sofosbuvir in June 2020, 400 mg per day. Five weeks later, she developed a slightly itchy erythematous and symmetrical rash on lower members. The patient initially suspected the treatment and she stopped it. Histological finding revealed a diffuse neutrophile infiltration of vessel walls confirming leukocytoclastic vasculitis. These lesions disappeared completely three days after drug withdrawal without any symptomatic treatment. Conclusions: Sofosbuvir is one of the several recent drugs that should be prone to further attention.